Nurse Case Mgr II

Elevance Health, Inc.; New York (NY); On-site; USD 79,000 - 119,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase and 401k contrib

Job summary

Elevance Health is seeking a Nurse Case Manager II in Latham, NY. This full-time role manages care for patients with complex needs, coordinating services and developing care plans to improve health outcomes.

The position requires an RN with 5+ years of clinical experience, a health-related BA/BS, and multi-state licensure. Compensation ranges from $79,464 to $119,196 per year, with standard benefits.

Qualifications

• BA/BS in a health-related field is required.
• Minimum of 5 years of clinical experience.
• Current, unrestricted RN license in applicable state(s).
• Multi-state licensure required if providing services in multiple states.
• Certification as a Case Manager preferred.

Responsibilities

• Ensure member access to services appropriate to their health needs.
• Conduct assessments to identify individual needs and develop care management plans.
• Implement care plans by facilitating authorizations/referrals as appropriate.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate the effectiveness of care management plans and modify as necessary.
• Interface with Medical Directors and Physician Advisors on care management treatment plans.
• Negotiate rates of reimbursement, as applicable.
• Assist in problem-solving with providers, claims, or service issues.
• Assist with the development of utilization/care management policies and procedures.

Skills

Clinical experience

Care coordination

Communication skills

Education

BA/BS in health-related field

RN license

Case Manager Certification

Job description

About This Role

The Nurse Case Manager II is responsible for performing care management for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans. This role is ideal for experienced nurses looking to make a significant impact on patient health outcomes.

Highlights

• Pay: $79,464 - $119,196/year
• Location: Latham, NY
• Schedule: Full-time, M-F 8am-4:30pm with 2-3 late evenings a month

What You’ll Do

• Ensure member access to services appropriate to their health needs.
• Conduct assessments to identify individual needs and develop care management plans.
• Implement care plans by facilitating authorizations/referrals as appropriate.
• Coordinate internal and external resources to meet identified needs.
• Monitor and evaluate the effectiveness of care management plans and modify as necessary.
• Interface with Medical Directors and Physician Advisors on care management treatment plans.
• Negotiate rates of reimbursement, as applicable.
• Assist in problem-solving with providers, claims, or service issues.
• Assist with the development of utilization/care management policies and procedures.

Requirements

Education:

• BA/BS in a health-related field required

Experience:

• Minimum of 5 years of clinical experience required

Licenses & Certifications:

• Current, unrestricted RN license in applicable state(s) required
• Multi-state licensure required if providing services in multiple states
• Certification as a Case Manager preferred

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase and 401k contribution

About Elevance Health

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. They are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels who are passionate about making an impact on members and the communities they serve.